- Stroke patients who use telehealth to recover at home do just as well as those who undergo physical rehabilitation at a clinic.
That’s the take-away from a study conducted by Dr. Steven C. Cramer at the University of California at Irvine. Presenting at the 2018 European Stroke Organization Conference in Gothenburg, Sweden, he said patients using telemedicine at home gain as much mobility – if not more – as those traveling to receive in-person rehab.
“Motor deficits are a major contributor to post-stroke disability, and we know that occupational and physical therapy improve patient outcomes in a supervised rehabilitation program,” Cramer, a neurologist and professor of neurology in the UCI School of Medicine, said in a news release issued by UCI. “Since many patients receive suboptimal therapy for reasons that include cost, availability and difficulty with travel, we wanted to determine whether a comprehensive in-home telehealth therapy program could be as effective as in-clinic rehabilitation.”
The six-week study, involving 124 stroke victims at 11 US sites, adds to the body of literature supporting physical therapy services delivered through telehealth and telemedicine not just for stroke, but a wide range of conditions, including post-operative care, chronic conditions and workmen’s comp cases.
Physical therapists and trainers have long sought to develop accepted exercise and rehab programs that allow them to oversee patients in their own homes. In some cases, group homes, assisted care facilities and senior living centers are using the platform to help individual residents or conduct guided group programs.
The movement toward telehealth-aided therapy is expected to gain momentum later this year when the Physical Therapy Licensure Compact goes live, giving physical therapists an expedited path to receiving licenses to practice in member states.
In his study, Cramer split the group of stroke victims - averaging 61 years old, 4.5 months post-stroke, with moderate arm motor deficits at study entry – into two groups, with half undergoing intensive arm therapy through a virtual platform and half undergoing in-person therapy. Those using telehealth were overseen by a licensed occupational/physical therapist.
When examined 30 days after the end of the therapy program, those using telehealth saw an improvement of 8.4 points on the Fugl-Meyer scale, which measures arm function on a scale of 0 to 66; those using in-person therapy saw an improvement of 7.9 points.
“The current findings support the utility of a computer-based system in the home, used under the supervision of a licensed therapist, to provide clinically meaningful rehab therapy,” Said Cramer, whose study was supported by the National Institutes of Health. “Future applications might examine longer-term treatment, pair home-based telerehab with long-term dosing of a restorative drug, treat other neurological domains affected by stroke (such as language, memory, or gait), or expand the home treatment system to build out a smart home for stroke recovery.”
“Getting patients to remain engaged and comply with therapy is a key measure of success of any rehabilitation program,” he added. “Greater gains are associated with therapy that is challenging, motivating, accompanied by appropriate feedback, interesting and relevant. Telerehab achieves this because therapy is provided through games, provides user feedback, can be adjusted based on individual needs, is easy to use – and is fun.”